Summary of learning from Tranche 1
88. Potential barriers to uptake of the vaccination programme on the grounds of inclusion or equalities issues have been identified and the programme has developed to address these.
89. Diversity. People experiencing homelessness were unlikely to receive postal invitations for their COVID-19 vaccinations (barrier) but pre-established and trusted relationships with healthcare services and third sector organisations (facilitators) enabled the delivery of drop-in clinics at homeless GP practices, temporary accommodation sites or other familiar settings.
90. Flexible delivery models. Bespoke outreach models were used to deliver COVID-19 vaccinations to population sub-groups who would face specific barriers to mass vaccination centres. For example, the Scottish Ambulance Service (SAS) drop-in clinics using a mobile vaccination unit. Outreach models were most successful when: (i) clinics were held in local, familiar and accessible community venues (e.g. places of worship, retail centres); (ii) community link workers were given adequate notice and time to enable promotion and advertisement, (iii) trusted community members attended clinics on the day (e.g. to provide encouragement and support). (iv) they specifically targeted people who would not otherwise have attended an appointment (some large employers facilitated on site vaccinations where employees were reluctant to take time off work).
91. Stakeholder engagement. Multi-partnership buy-in and action, spanning from high-level organisational leaders to ground-level population representatives, was key in delivering inclusive actions. Engagement with individuals and organisations who were in regular communication with communities (e.g. third sector, healthcare providers, local authority services, faith leaders) was especially important in understanding specific barriers that were being faced by different population sub-groups and what actions would be helpful to overcome these barriers. These stakeholders provided trusted voices and had well-established networks through which to deliver key vaccination messages.
92. Communications and information. Tailored information about the COVID-19 vaccines had to be considered for all population sub-groups. Key points were that messages should be: (i) Clear and unambiguous, (ii) up to date, (iii) timely, (iv) address key questions or concerns that different population sub-groups had, (v) available in multiple formats (different languages, written and audio-visual, easy-read), (vi) available on multiple platforms (websites, social media, hard copy leaflets, TV, radio, webinars, telephone), (vii) delivered by trusted individuals.
93. Data. Collecting and analysing real-time data on vaccine uptake by basic demographics (postcode, age, gender, ethnicity, religion) is key to understanding the effectiveness of current delivery models and highlighting geographical areas or population sub-groups for whom additional resources to support and deliver COVID-19 vaccines was required. Early in the vaccination programme a lack of data on vaccine uptake made it difficult to plan effective use of resources. However, we developed high-quality data to identify geographical areas of poorest uptake and this was used to inform where mobile vaccination units and pop-up clinics could be located.
94. Equity. Populations which experience the greatest barriers require greater resource to promote and support vaccination uptake. Outreach clinics in local Mosques, for example, required additional time and resources to delivery bespoke clinics, but reached populations of undocumented migrants who would never have attended mass vaccination sites.
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